Psychiatric referrals from a renal unit: a study of clinical practice in a British hospital.

Renal patients referred for a psychiatric opinion were compared with patients from the same unit who had never seen a psychiatrist. Overall the referrals had more psychiatric symptoms, but syndrome profiles of the two groups were very similar. In diagnostic terms, the referrals differed in having a range of adjustment disorders characterised by changes other than simple mood disturbance. There were relatively few major mental illnesses. Three other factors were associated with referral: youth, absence of a confiding relationship; and currently receiving haemodialysis. Most referrals were managed with short term non-intensive therapies, and there was little need for psychiatric in patient care. Psychiatric disorder did not influence survival. The significance of these findings for renal unit psychiatry is discussed.